According to IRDAI guidelines and standard policy conditions, what is the correct requirement for intimation of hospitalization for cashless claims?

hard Q10 of Q15

Insurance Awareness - Health Insurance

AIntimation must always be given within 24 hours for all hospitalizations

BIntimation must be given only after discharge from the hospital

CIntimation is required as per policy terms—typically 48 hours prior for planned hospitalization and within 24 hours for emergency hospitalization

DIntimation is not required for cashless claims at network hospitals

Step-by-Step Solution

Step 1: Understand hospitalization intimation rules
Cashless claims require timely intimation to the insurer to enable pre-authorization and claim processing.
Step 2: Distinguish planned and emergency cases
For planned hospitalization, intimation is usually required 48 hours in advance, while for emergency hospitalization, intimation is generally required within 24 hours of admission, as per policy terms.
Final Answer:
Intimation is required as per policy terms—typically 48 hours prior for planned hospitalization and within 24 hours for emergency hospitalization → Option C
Quick Check:
Planned = prior intimation; Emergency = within 24 hours.

Quick Trick: Planned → 48 hrs before; Emergency → within 24 hrs.

Common Mistakes:

MISTAKES

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